HIV infection and poor nutritional status often exist in tandem. The infection increases the body’s energy requirements and diminishes the body’s ability to absorb nutrients. Also, clients with opportunistic infections or adverse drug side effects may have poor appetite or difficulty with eating. The nutritional status for people living with HIV/AIDS (PLHA) or tuberculosis (TB) has significant impact on clinical outcomes, disease progression and antiretroviral therapy or TB treatment success.

Currently, 33% of Ugandan children less than five years of age are stunted, 16% are underweight, and 4% are wasted. Malnutrition among adults is also high, with 12% of women being underweight. Other forms of malnutrition do exist and with HIV infection they become aggravated.

USAID/SUSTAIN supports facilities to integrate nutrition assessment, counseling and support (NACS) in routine service delivery for HIV care and at all entry points using the seven-step approach developed by the USAID-funded NuLife—Food and Nutrition Interventions for Uganda project.

NACS Approach

In accordance with the Ugandan Ministry of Health (MOH) National Guidelines for Infant and Young Child Feeding and Nutrition, USAID/SUSTAIN also supports healthcare workers at HIV entry points (e.g. antenatal care and young child clinics, maternity wards and post-natal care units) and HIV chronic care/antiretroviral therapy clinics to promote optimal and safe feeding practices for infants and children. Good infant and young child feeding and nutrition (IYCFN) practices are essential in prevention of mother-to-child transmission (PMTCT) of HIV and ensuring healthy outcomes for HIV-exposed infants.

Partnerships for Nutrition

The USAID/SUSTAIN project is partnering with Production for Improved Nutrition (PIN) project to supply ready-to-use therapeutic food (RUTF) to support care for HIV-infected clients who are severely malnourished.


  • Between October 2016-September 2017, 52,987 out of 53,600 clients in HIV care and treatment were nutritionally assessed. From FY 18 (Q1-Q2), in Northern Ugandan facilities,  230,289 out of 256,793 clients in HIV care and treatment were nutritionally assessed.
  • A total of 3,137 HIV-positive clients were identified to be acutely malnourished and 1,802 clinically undernourished PLHIV received therapeutic or supplementary food (October 2016 -September 2017). In FY 18 (Q1-Q2), 1,031 HIV-positive clients were identified to be acutely malnourished and 739 clinically undernourished PLHIV received therapeutic or supplementary food.
  • Healthcare providers were trained to provide nutrition services (2010-September 2017) on the following topic areas: comprehensive nutrition care and support for PLHIV (130); integrated nutrition assessment counseling and support (115); sensitization of leaders (181); training health workers on the 20-hour baby-friendly hospital initiative (BFHI) course (720); and training of trainers on BFHI (30).
  • 518 healthcare workers including nurses, midwives, clinical officers and nursing assistants drawn from the Out-Patient Departments, HIV, Antenatal, Postnatal and Young Child Clinics, Nutrition, Tuberculosis and Medical wards were trained in the updated Nutrition Assessment Counseling and Support (NACS) curriculum.
  • All health facilities have been equipped with anthropometric equipment (including weighing scales, MUAC tapes and infantometers) and IEC materials to improve quality of service delivery.

 Learn more in our Nutrition technical brief!